Alarming Tuberculosis Rate among People Who Inject Drugs in Vietnam

Nicolas Nagot, Vinh Vu Hai, Thuy Thi Thu Dong, Oanh Khuat Thi Hai, Delphine Rapoud, Giang Thi Hoang, Catherine Quillet, Khue Pham Minh, Roselyne Vallo, Thanh Tuyet Thi Nham, Joëlle Castellani, Jonathan Feelemyer, Don C. Des Jarlais, Lan Phuong Nguyen, Hoi Van Le, Nhung Viet Nguyen, Luan Nguyen Quang Vo, Huong Thi Duong, Jean Pierre Moles, Didier Laureillard

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The tuberculosis (TB) epidemic is not homogeneous in the general population but presents high-risk groups. People who inject drugs (PWID) are such a group. However, TB among PWID remains largely undocumented. Our goal was to assess the prevalence of TB and the risk factors associated with TB among PWID in Vietnam. Methods: We implemented a cross-sectional survey among 2 community-based cohorts of human immunodeficiency virus (HIV)-positive and HIV-negative PWID in Hai Phong. Participants were screened for TB using questions on TB symptoms. Those who reported any symptom were accompanied by peers to the TB clinic for chest x-ray. If the latter was abnormal, a sputum was collected to perform an Xpert MTB/RIF test. Results: A total of 885 PWID were screened for TB. For both cohorts, most PWID were male (>90.0%), with a median age of 42 years. Beside heroin injection, 52.5% of participants reported smoking methamphetamine, and 63.2% were on methadone. Among HIV-positive PWID (N = 451), 90.4% were on antiretroviral therapy and 81.6% had a viral load <1000 copies/mL. Using a complete-case analysis, the estimated TB prevalence was 2.3% (95% confidence interval [CI], 1.0-4.5) and 2.1% (95% CI, 0.8-4.2) among HIV-positive and HIV-negative people, respectively. Living as a couple, arrest over the past 6 months, homelessness, and smoking methamphetamine were independently associated with TB but not HIV infection. Conclusions: In the context of very large antiretroviral therapy coverage, this extremely high rate of TB among PWID requires urgent actions.

Original languageEnglish (US)
Article numberofab548
JournalOpen Forum Infectious Diseases
Volume9
Issue number2
DOIs
StatePublished - Feb 1 2022

Keywords

  • drug users
  • epidemiology
  • prevalence
  • risk factors
  • tuberculosis

ASJC Scopus subject areas

  • Oncology
  • Clinical Neurology

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